"That is happiness; to be disolved into something complete and great. When it comes to one, it comes as naturally as sleep." - Willa Cather

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Saturday, 7 March 2009

Proposed guidelines for pregnancy weight gain

It's been a while since I talked about pregnancy. And no, I'm not pregnant. I just ran across new proposed pregnancy weight gain guidelines from Raul Artal, M.D., chairman of the department of obstetrics, gynecology and women's health at Saint Louis University in Missouri. He is suggesting these prior to the official release of revised guidelines from the Institute of Medicine (IOM).

I have to admit that these numbers make sense to me. But I also recommend that pregnant women who read this blog listen to their own bodies and discuss weight gain concerns with their doctor or midwife.

It will be interesting to see what the IOM's final recs are in June of 2009.

I found the website through a great blog about exercise, pregnancy, etc, http://xapis.wordpress.com/ I have a link on the right hand column under Running In Pregnancy Links (It's called This Dreamcrossed Twilight).

In other news, our life has become pretty happy here in Næstved. It's not easy to leave the entire life we knew (plus two wondeful kids) for another country. It's been especially hard for SR.

But we know step daughter is coming and we feel great about that. I think she'll just love it here.

We have our favorite running spots and SR is runnning really fast these days. We're looking forward to a half marathon coming up in a few weeks.

We have found good jobs and I just applied for money to start a PhD project.

And then there's The Lorax. Here he is with grandma in one of the rare moments when he doesn't have banana in his hair.

He actually started drawing a bit yesterday. He saw me writing on some paper and then took the pen from me and started doodling. He ended up with a pretty good drawing:

10 comments:

Whoa holy misrepresentation! I went to that blog. The link you mention (which is from Feb 20 to give a shortcut to other readers, you have to scroll through a lot of what clearly reads as weight-obsession, and not in a category I'd see as healthy, to get there), to find these "guidelines". They are unreferenced, except to a different general website, and even one of the comments on that site notes that it seems to be a rogue guideline. Those guidelines are extreme. Seriously sealegs, I lurk on your blog because your disordered eating and bizarre ability to justify any of your actions fascinates me, but it also makes me really sad. Get some help. You are right to be concerned about how your messed up attitude towards food and body weight are going to be inherited by your stepdaughter, and even your son as he grows and sees you as the archetypical woman. Your attitudes towards food aren't healthy. One of the most important phrases I came across in my own readings on exercise and pregnancy came from the only guy who really did systematic research on pregnant women, who noted that "competitive athletes" who are pregnant (and I paraphrase) tend to ignore medical advice because in their pursuit of athletic objectives, they feel deep down "they know what is best for their body and baby" and as a result will go to extreme measures to do whatever they feel is right to justify that. You seem to be the poster child for that sentiment.

Oh and PS. Tracked down the original article on Fit Pregnancy. It's one doctor, the mysterious "institute of medicine" isn't specified, there are no scholarly articles referenced, in fact, no references and all. C'mon Sealegs. Be a scientist about this. Furthermore, the article is about obese people and weight gain in pregnancy, not people on the low end of the BMI scale, such as you and the other blogger. There is absolutely no discussion of weight gain in categories for those people by the doctor or even the journalist.

I'm not sure why this issue irks me so much, other than the fact that I am pregnant. I also want a healthy pregnancy, and don't fancy blimping out. So I went to a nutritionist, who helped redirect me towards thinking about the nutritional needs for me and my growing baby, instead of obsessing about pounds gained. My weight gain is under control, but not because I'm dieting and freaking out about pounds on the scale, but because I'm eating the right things in the right amounts.

I write these posts because the health of women as well as their babies is so important to me. And it really is an interesting subject. My intetion is not to distort data.

The author of the article I cited, Laurie Tarkan, is an author for the New York Times. Dr. Artal is legitimate, as far as I know. His recs, however, may end up being much lower than what the IOM finds to be safe.

I appreciate your criticism. I did look up quite a bit more on the subject just to be sure I wasn't leading everyone astray. And it is just one doctor who is recommending these weight gains, but there is a general consensus from all I have read that the IOM will lower the weight gain recs later this year.

But, I am so freaking sick of everyone out there needing to put 'guidelines' on everything pregnancy related. Every woman is different. She starts her pregnancy different, she goes through her pregnancy different, and she ends up different.

People get so caught up in putting out what is appropriate that they make those who are outside the 'guidelines' feel as if they are doing something wrong.

I am currentyly 15 weeks pregnant and have gained 18 lbs. Yes, you heard that right - 18 stupid lbs. I started this pregnancy at 116 (I'm 5'3 and 32 yo) and have maintained my weight through the years through a combination of running and calorie restriction. Being pregnant, I have chosen not to calorie restrict and major foot surgery has prevented routine exercise.

But, guess what, I am not a horribly bad person even though I am currently about 10 lbs above where I "should" be. I just wish that people would focus on what is important -- birthing a healthy baby and being healthy yourself. If that means gaining 15 pounds, 60 pounds, or 0 pounds then so be it. Enough is enough.

I've also looked at Dr. Artal's various articles on pregnancy and weight gain. He is a recognized authority on the subject with many studies backing up his recommendations. His proposed guidelines, far from being "rogue" opinions, may in fact influence future policy on weight gain during pregnancy.

Although Wannabe is right that his studies focus mainly on the obese woman, the fact of the matter is that USA general guidelines are likely be revised in the downward direction next year simply because women in this country tend to gain excessive weight during pregnancy, and tend to start pregnancy at higher BMIs than they did when the 25-35 pound guidelines were established 18 years ago.

Dr. Artal's proposed guidelines may seem extreme, but only because our current guidelines may be too extreme on the high end. The "healthy" weight gain guidelines in this country may simply be too high. I think that is what Sea Legs is pointing out.

I do agree with Bec that pregnant women are bombarded with "guidelines" and, as a pregnant woman myself, I know it gets old fast! However, I personally see nothing wrong with trying to hold one's weight gain down during pregnancy as long as the baby is healthy and growth is on target. That's the bottom line - not pounds.

I'm glad that sealegs changed her original post to have more facts, and to reference the actual news article instead of repeating the post of another blogger. However, I disagree with you, Enthused. SLG has been at this long enough that she's not merely trying to point out that "the "healthy" weight gain guidelines in [the USA]may simply be too high." She's looking for justification of her own extreme eating patterns. Sealegs focuses on those who start out skinny and want to keep the amount that they gain to a bare minimum. That's very different from being concerned about people who start out obese and use the current guidelines to pack on another 35 pounds. SLG is a clever woman who forum shops for doctors and nutritionists until she finds one who tells her what she wants to hear, and she hides her eating disorder behind a "concern about obesity" which is clearly, as someone who's last post was all about how she got her weight under 50kg by eating oatmeal, gum, and chocolate treats, not her agenda.

And so I repeat what I said earlier today. I've seen a lot of commenters sugar coat their reactions to her extreme behavior on this blog, but I'm going to call it bluntly: SLG, get some help.

Let's be honest; people come here to read the words of the crazy over-the-top dieting runner. She writes honestly about her diets and training. How she diets and how she trains is probably a lot less unusual than we think. The fact that she is willing to write about it is very unusual.

Then there is the doctor reviewing research. I do not believe you will be able to find a more comprehensive site discussing pregnancy weight gain. She isn't "just one doctor" with recommendations. In fact, she never claims to have any specialty expertise in this matter. Instead, she quotes studies and experts.

The fact that the Institute of Medicine is now changing their guidelines is a big deal. What she blogged about 18 months ago made people so upset they were trying to report her for child abuse. Now, it will be a national guideline. Even the OBs were uneasy about the weight gain just 18 months ago and now it's what they will be recommending to all patients.

So don't confuse the two sides to this blog. There is the vulnerable angsty personal side and there is the physician scientist side. Maybe she should have two different blogs, but I fear no one would read the physician scientist one.

I just want to reiterate again who my rant was and was NOT directed at...

As I started with, SeaLegs, my rant was not at you. Who it is at is the insatiable societal need to put guidelines around everything pregnancy and motherhood related (see back to your working moms piece).

Should a woman gain *only* 15 lbs during pregnancy, she must be abusing her fetus and should be turned into the authorities.

Should a woman gain *holy hell* 60 lbs, she must be a total sloth and could care less about the future obesity of her child.

Should a woman work o/s the home and send her kids to day care she is somehow depriving them of a traditional upbringing.

Should a woman stay home with her daughter, she must not be a feminist and therefore is teaching her daughter that men should be the ones who work and rule the world.

Enough is enough is enough.

People are individuals -- I wish society and readers and etc would stop imposing their ideals and viewpoints on others.

Hello from Rude Skov

Photo by Stine Sophie Winckel

...

My name is Tracy. I am a physician scientist from the USA, living with my husband and two young boys in Denmark. I work as a post-doc fellow at Næstved Hospital. I have a scientific interest in vision loss, vision loss during exercise, exercise, running during pregnancy, MAF training as well as nutrition and health for athletes. I also have a love for music, physics, statistics, cycling, yoga, cross-country skiing, bla bla bal.

I was a member of Team USA at the IAU World Championships in Ultra Trail Running in 2013 in Wales. I am now training to run with Team Denmark at the IAU World Championships in Annency, France in May 2015.